I thought about what makes dementia care rewarding for me and I realized it is ‘keeping the connection’ with that person for as long as possible. The challenge with dementia is that the person may be in the later stages and not be able to tell you their passion. They also are a moving target and as the person declines we often accept that they can no longer do a certain skill anymore. eg a lady may no longer be able to knit.
In my mind, it is the role of the carer to adapt to the person with dementia’s current abilities and not just accept that a skill is gone, but be determined to find a way to make that passion or skill continue to have meaning to the resident. With the knitting example if the person can no longer knit, they may feel like a failure and lose confidence in themselves, and this may lead to depression. What sort of things could we do to make that knitting skill relevant to her???
I thought long and hard about this and I probably would obtain a whole bag of different coloured balls of wool and offer them to the resident to try and sort into colours. It doesn’t matter whether she is correct – it is whether the person is engaged in doing so that matters. Does she like holding the wool? Is she feeling the texture of the wool? Is she comforted by having wool on her lap? Can she still hold the knitting needles? I would bring in a knitted baby jacket and watch her reaction. Does she light up? Does it spark a conversation or feeling within her?
Maybe the resident is further along the journey and cannot respond in any way, so we have to become more creative. We could talk with the resident about knitting and what experiences we may have had with it. It may be a one sided conversation, but it is her eyes that are the gateway to what she is thinking. We could sit next to her and place the wool on her forearm and just stroke her skin with it to see if she has feeling. Does the warmth make her feel comforted? What happens when you place a knitted lap rug over her? Does she draw it towards herself?
I know nothing about knitting but it is a great opportunity for me to learn a new skill. If the person with dementia was still able to knit I would get her to teach me. Asking questions about what type of items she has knitted for her family members can spark an engaging conversation about a certain period in her life. Unlocking these passions again is what caring is about for me. The day to day tasks such as meals and tv and activities is mundane, but to tailor an activity around a passion of a resident and make them the ‘star/focal point’ for that day can make them feel really special and empower them for that moment.
I would like to see caring performed at a ‘deeper level’ in the future and if I was a team leader or supervisor I would like to actually ask the carers some questions to indicate their interactions with the resident eg. Tell me what what you learnt about Mrs Johnston this week? ….Was there anything you did this week with Mrs Johnston that you felt engaged her? Have you noticed any declines in her abilities?…How do you think we can deal with this?…Do you have any ideas with how we can bring out the best in this resident?
Our carers and nurses are so used to doing ‘tasks’ that the person with dementia’s feelings and self esteem is the element of caring that is being sacrificed when the resources are stretched. Most carers do what they do because they actually care about people. If you do not empower the carers to spend time making a difference to each person, they are actually bored as well and just doing tasks because they have to. If we lose this ‘person orientated’ focus, the residents will die of boredom. The light within them will go out and this will be really sad.
Something to think about……